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    Blood transfusion in pediatric intracranial tumor surgery
    (Bmc, 2024) Soner, Huelya Tosun; Oygen, Oemer; Guvenc, Bayram; Turkan, Rojda Tanik; Sener, Fuat; Soner, Serdar; Uzundere, Osman
    Background Pediatric central nervous system tumors are the most common solid tumors in children and leading cause of cancer-related morbidity and mortality. Various factors may influence the practice of blood transfusion during this tumor diagnosis. The primary aim of this study was to determine the factors that may influence intraoperative blood transfusion in pediatric patients undergoing surgery for intracranial tumors and to predict patients who may require blood transfusion. Methods A retrospective study was performed in all pediatric patients younger than 15 years who underwent craniotomy for brain tumor removal from January 2018 to December 2023 in our institution. Preoperative, intraoperative and postoperative data were collected from medical and store anesthesia records. The predictors of intraoperative blood transfusion were determined using multivariate logistic regression. Results A total of 138 patients were enrolled in the study, of whom 62 (44.9%) required intraoperative blood transfusion. In multivariate regression analysis age < 4 years and operating time > 490 min were determined as independent variables in terms of need for intraoperative blood transfusion. It was determined that the need for transfusion was higher in patient who were operated on urgently and patients with comorbidities (p = 0.023, p = 0.005). Conclusion In conclusion, the findings obtained in this study suggest that age and surgical duration are independent risk factors for intraoperative blood transfusion in pediatric patients undergoing surgery for intracranial tumors. Particularly, in younger patients and prolonged surgeries, closer monitoring and awareness may enhance early detection, leading to the prevention of complications.
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    Comparison of The Effects of Low Flow Desfluran and High Flow Desfluran on Oxidative Stress and DNA Damage in Anesthesia Applications
    (Reial Acad Medicina Illes Balears, 2024) Soner, Hulya Tosun; Kaplan, Ibrahim; Uzundere, Osman; Soner, Serdar; Celik, Feyzi
    Background: Studies have reported that volatile anesthetics may affect genotoxic and oxidative stress in the present study, we aimed to compare low and high flow anesthesia techniques in terms of DNA damage and oxidative stress. Methods: We included 60 patients who underwent high and low flow desflurane anesthesia, and those who underwent low and high flow anesthesia were categorized in Groups I (n=31) and II (n=29), respectively. The hemodynamic and respiratory parameters of the patients were recorded and 8-OhdG (8-hydroxy deoxyguanosine) values for DNA (deoxyribonucleic acid) damage, MDA(Malondialdehyde), cystatin C, TAS (total antioxidant status), TOS (total oxidative status), and LPO (lipid peroxid) values for oxidative stress were measured from the blood samples collected from the patients preoperatively, intraoperatively at the third hour and at the postoperative twenty-fourth hour. Results: Postoperative MDA value was significantly higher in the high flow group than in the low flow group (p<0.05). There was no significant intergroup difference in terms of TAS, TOS, cystatin C, LPO and 8 OhdG values (p>0.05). Conclusion: In conclusion, MDA values, an indicator for oxidative stress, increased significantly in high flow desflurane application. There was no intergroup difference in terms of DNA damage.
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    Öğe
    Effect of non-invasive bilateral sphenopalatine ganglion block on postoperative pain in patients undergoing septorhinoplasty surgery: a randomized controlled study
    (Edizioni Minerva Medica, 2024) Tosun Soner, Hulya; Haznedar, Berzan; Soner, Serdar; Erdal Erbatur, Meral; Acil, Fatma; Kaya, Sedat; Uzundere, Osman
    BACKGROUND: The objective of this study was to assess the impact of preoperative sphenopalatine ganglion block (SPGB) on postoperative pain and assess intraoperative and postoperative analgesic consumption in patients undergoing septorhinoplasty. METHODS: In this prospective, randomized controlled study, 72 patients were included and divided into two groups: group 1 (36 patients) received the sphenopalatine ganglion block (SPGB), while group 2 (36 patients) served as the control group. Patient assessments, using the numerical rating scale (NRS), were conducted at the postoperative first hour, fourth hour, and 24 t h hour. Additionally, intraoperative hemodynamics, analgesic requirements, and postoperative analgesic requirements were documented. RESULTS: The patients in group 1 exhibited significantly lower NRS scores at postoperative first, fourth, and 24 t h hour than those in group 2 (P<0.001 for all three time points). Additionally, the mean Riker Sedation-Agitation Scale (RSAS) scores were significantly lower in group 1 than in group 2 (P=0.006). Both intraoperative remifentanil use and postoperative analgesic consumption were significantly higher in patients in group 2 (P<0.001 and 0.004, respectively) than those in group 1. Analysis of intraoperative heart rate and mean arterial pressure (MAP) revealed that patients in group 1 had lower postoperative heart rates (P=0.040) than those in group 2, and MAP values after intraoperative block, at 30 min, and postoperatively were significantly lower (P=0.005, P=0.001, and P=0.034, respectively) than those in group 2. CONCLUSIONS: We advocate for the adoption of the noninvasive SPGB method in patients undergoing septorhinoplasty surgery. This approach significantly reduces the need for intraoperative analgesics, alleviates postoperative pain, and reduces the demand for postoperative analgesics. Moreover, it improves the overall surgical experience because of its ease of application, contributing to a more comfortable surgical process.
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    Öğe
    Is There a Relationship between Anxiety-depression Level and SYNTAX Score in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention?
    (2024) Kaya, Ahmet Ferhat; Yılmaz, Cemalettin; Özdil, Mehmet Hasan; Soner, Serdar; Özbek, Mehmet
    Amaç: SYNTAX (PCI with TAXUS ve Cardiac Surgery arasındaki SYNergy) skoru, koroner arter hastalığı olan hastalarda hastalığın ciddiyetini ve yaygınlığını değerlendirmek için kullanılan kantitatif bir skorlama sistemidir. HADS (Hastane Anksiyete ve Depresyon Ölçeği), hastaların anksiyete ve depresyon düzeylerini ölçen bir ölçektir. Psikososyal stres ve ateroskleroz arasındaki ilişki iyi bilinmektedir. Bu çalışmada akut koroner sendrom (AKS) nedeniyle perkütan koroner girişim uygulanan hastalarda SYNTAX skoru ile HADS arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntem: Çalışmamıza AKS'li toplam 130 hasta dahil edildi. İki bağımsız girişimsel kardiyolog tarafından hesaplanan SYNTAX skoru 0-22, düşük; 23-32, orta; 33 ve üstü, yüksek olarak üç gruba ayrıldı. Çalışmamızda, hastaların anksiyete ve depresyon düzeyleri AKS'den bir ay sonra HADS ile değerlendirildi. Bulgular: SYNTAX skoru 0-22, 23-32, >33 grubunda sırasıyla 68, 39 ve 23 hasta saptandı. Yüksek SYNTAX puanı ile HAD-depresyon ve anksiyete ölçeği arasında anlamlı bir ilişki gözlendi (sırasıyla p<0.001, p<0.001). Korelasyon analizinde SYNTAX puanı ile depresyon düzeyi arasında pozitif yönde orta düzeyde, SYNTAX puanı ile kaygı düzeyi arasında pozitif yönde zayıf bir ilişki bulundu (sırasıyla r=0.642, r=0.538). Sonuç: Çalışmamızda perkütan koroner girişim uygulanan AKS hastalarında HADS ve SYNTAX skorları arasında anlamlı korelasyon saptandı.